Corrosive oesophagitis usually occurs from accidental or suicidal ingestion of caustic substances (e.g. lye, household cleaners, bleaches, washing soda), and is harmful to the oesophagus due to their alkali medium. The stomach is not affected as the gastric acid can neutralize these substances, however, in cases of acidic corrosives, the oesophagus can be spared while the stomach is severely injured.
The oesophageal damage depends on the concentration of the harmful material and the time of contact between it and the oesophagus. It usually affects the middle and lower third of the oesophagus.
- acute stage: in the first 10 days from ingestion; acute necrosis with mucosal blurring and dilated atonic esophagus
- subacute stage: 10-20 days after ingestion and characterised by esophageal ulceration
- chronic stage: occurs after 21 days with oesophageal inflammation healed by fibrosis resulting in stricture
Water-soluble contrast medium is preferred in the acute stage. Findings in acute stage include mucosal oedema, ulceration and sloughing of the mucosa with oesophageal dilatation and atony. Complications seen in this stage can include perforation and leakage; the same findings can be seen in the subacute stage with mild oesophageal narrowing.
Barium contrast can be used in the chronic stage; there are single long or multiple strictures involving the middle and lower oesophagus.
Oesophageal perforation and increased incidence of squamous cell carcinoma of the affected segment.
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